BLOOD SYSTEMS INC

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

COURTYARD FOUNTAINS

• Clean and refill fountains

  Yes

  No

  N/A

Cooling towers

• Check for leaks

  Yes

  No

  N/A

• Perform water treatment testing

  Yes

  No

  N/A

PARKING

• Walk property

  Yes

  No

  N/A

• Porter parking

  Yes

  No

  N/A

CORP

• Check common areas

  Yes

  No

  N/A

• Check break room

  Yes

  No

  N/A

• Check restrooms

  Yes

  No

  N/A

UBS

• Check common areas

  Yes

  No

  N/A

• Check breakroom

  Yes

  No

  N/A

• Check restrooms

  Yes

  No

  N/A

FLW

• Check common areas

  Yes

  No

  N/A

• Check conf rooms

  Yes

  No

  N/A

• Check restrooms

  Yes

  No

  N/A

• Signature of inspector

  Sign

• Notes